Brain Scans Aid Prisoner Rehab

— More than half of released inmates in New Mexico return to prison, but a study of state prisoners suggests brain scans can predict which criminals will re-offend. Dr. Kent Kiehl, the study’s author, said he hopes his work can help reduce those numbers.

Kiehl, a psychologist at the Mind Research Network in Albuquerque, used a portable fMRI machine to image 96 prisoners’ brains at the Western New Mexico Correctional Facility in Grants and the Penitentiary of New Mexico near Santa Fe. He then tracked the prisoners for four years after their release.

He explained that, “We know that certain forms of impulsivity predict whether or not you re-offend.” Rather than using a questionnaire or psychological evaluation, his method attempted to measure impulsivity directly using an fMRI to image the brain during a series of tasks that required self-control.

The test worked something like this: A series of letters was presented rapidly on a screen, one at a time. The test subject is instructed to press a signal button only when the letter X appears. If the letter K appears, he’s told not to push the button.

The fMRI detects changes in oxygenation in the brain. When a region of the brain is active, blood flow increases, just as it does to muscles during exercise. Kiehl focused on activity in the anterior cingulate cortex, which sits in the center of the brain toward the front of the skull. Research has shown this cortex plays a key role in regulating behavior and emotion.

Increased blood flow to the anterior cingulate cortex during the test indicated better emotional regulation. Prisoners that had low activity in this area of the brain during the test—the more impulsive prisoners—were up to four and a half times more likely to commit another crime.

High scores on impulsivity tests can indicate a range of disorders, such as psychopathy, bipolar disorder, brain injuries or even drug withdrawal. Very impulsive people have difficulty weighing long-term consequences over short-term gains. When inmates go up before the parole board, an impulsivity test is one of the ways that the board determines if they are likely to re-offend once released.

The Cost of Prisons

Taxpayers pay dearly for the American prison system. The United States spends $74 billion per year on corrections. America imprisons more of its population than any other country in the world. Its incarceration rate is roughly the same as the Soviet Union pre-World War II, after Stalin imprisoned millions of people in the gulag system.

Caring for inmates is expensive. New Mexico spent about $35,000 per inmate last year. Comparatively, state spending per K-12 student was $10,812 in 2009-2010. And New Mexico spent only $93.37 per capita on mental health agencies in 2010.

“I use these numbers to help people realize, holy cow, we spend a lot on prisons,” said Kiehl. “The best way to reduce those costs? Through treatment.” Kiehl said corrections facilities have been receptive to his work, although he added that “I generally think the state should adopt better procedures to reduce recidivism and reduce prison populations rather than having to rely on private prisons.”

New Mexico has a higher proportion of its inmates in private prisons than any other state. The Presbyterian Church, when calling for the abolition of private prisons in a statement, argued: “Since the goal of for-profit private prisons is earning a profit for their shareholders, there is a basic and fundamental conflict with the concept of rehabilitation as the ultimate goal of the prison system.” The incarceration industry spends millions lobbying for longer sentences and harsher punishments.

Proponents of private prisons say they are more cost-effective and efficient than public prisons, and that they’re an effective way to deal with a booming prison population.

A Better Way to Prevent Crime

Many articles on Kiehl’s research reference the movie Minority Report to highlight the thorny ethics of using brain imaging to influence incarceration. In the film, crimes can be predicted ahead of time, and potential criminals are imprisoned before they’ve done anything illegal.

Kiehl countered that risk assessments, which evaluate an inmate’s potential danger to society upon release, are already commonplace in the criminal justice system. Parole, sentencing and other decisions often hinge on such analysis, usually measured through personality tests or a clinical evaluation.

His research could lead to better risk assessments and improved treatments, Kiehl argued: Since the scans directly measure brain activity rather than relying on the test’s outcome, the results are more accurate. Still, he admitted, the science is in its infancy.

Kiehl said he’s confident risk assessment is the best way to reduce the chance that people reoffend, but he says that many of the officials engaged in risk assessment for parole boards have little or improper training. “People have abused risk assessments to keep someone in prison. The adversarial process can distort some of the best scientific tools.”

Research at the University of Virginia confirms that that scores on a psychopathy test change depending on who administers the test. Paid experts demonstrate marked bias; when compared to psychologists testing on behalf of the defendant, psychologists hired by prosecutors tend to conclude that the prisoner is higher risk.

Developing Effective Treatments

California has evolved into a dramatic example of how crucial these assessments can be. The state, under court order to reduce prison overcrowding, has to release at least 33,000 prisoners. Part of the state’s plan to comply includes analysis to determine which prisoners it could safely release—in other words, which are low-risk.

Bernalillo County is also under pressure to reduce overpopulation at the Metropolitan Detention Center, though it’s still unclear how the jail will do so.

The goal of his research, said Kiehl, is rehabilitation—not further incarceration. “If I could give you a treatment or a pharmaceutical that reduces impulsivity and that leads to people not committing crimes and coming back to prison, that’s a fantastic thing for the inmate and society.”

Such treatments would be only one aspect of a successful release plan, he added. Many risk factors can be treated through common-sense measures: regular drug testing, guaranteed employment, or anger or impulse management therapy. That treatment, he said, is crucial to reducing prison overcrowding and the cost to the public. A 2012 New Mexico Department of Corrections report estimates that reducing recidivism by 10 percent would save the state $8.3 million a year and reduce victim costs by $40 million.

Treatment results in the best outcome for both society and prisoners, Kiehl said. “I teach the economics of treatment. If you treat people, especially youth offenders, you can reduce the chances by 50 percent that they will come back to criminal behavior,” he noted. “That is unbelievably cost-effective.”

Research from the nonpartisan Washington State Institute for Public Policy indicates effective treatment programs cost less than $5000 per offender and return up to $20 in benefits for every dollar spent by taxpayers.